Differential Diagnosis for Tenderness Top Right of Centre Umbilical Region
Single Most Likely Diagnosis
- Peptic ulcer disease: This is a common cause of abdominal pain in the upper mid-abdomen, which can sometimes be referred to as the umbilical region, especially if the pain is high enough. The tenderness could be due to an inflamed ulcer.
Other Likely Diagnoses
- Gastroenteritis: Inflammation of the stomach and intestines can cause abdominal tenderness and pain, which might be localized to the upper mid-abdomen.
- Constipation: Severe constipation can cause abdominal pain and tenderness, potentially in the mid-abdomen if the constipation is significant.
- Irritable Bowel Syndrome (IBS): While IBS can cause a variety of symptoms including abdominal pain, the pain is often diffuse or lower abdominal. However, some patients might experience upper abdominal pain.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents with pain in the lower right abdomen (McBurney's point), atypical presentations can occur, especially in early stages or with an retrocecal appendix. Missing appendicitis can lead to severe consequences.
- Intestinal obstruction: This is a serious condition that requires prompt medical attention. The pain can be diffuse or localized and might be accompanied by vomiting, constipation, and abdominal distension.
- Mesenteric ischemia: This condition involves insufficient blood flow to the intestines and can present with severe abdominal pain out of proportion to the physical examination findings. It's a medical emergency.
Rare Diagnoses
- Meckel's diverticulum: A congenital anomaly of the small intestine that can cause abdominal pain, usually in the lower abdomen but potentially higher if the diverticulum is located more proximally.
- Inflammatory bowel disease (Crohn's disease or ulcerative colitis): These conditions can cause chronic abdominal pain and tenderness but are less common than other causes of abdominal pain.
- Abdominal wall pain (e.g., from a hernia or muscle strain): While not typically life-threatening, abdominal wall issues can cause significant pain and tenderness that might be localized to the area of the umbilicus.